Abstract
As exact knowledge of the lymph system which plays an important role in the metastasis of uterine cancer is indispensable in the diagnosis and treatment of cancer of the uterus. According to the studies on the lymphatic system of corpus uteri by various investigators, the draining lymphatic ducts of corpus uteri mainly run in two directions, namely, one toward the outside of the pelvis and the other into the pelvis, and as for the regional lymph nodes outside the pelvis the lumbar nodes are pointed out and those for inside the pelvis the hypogastric lymph nodes. Despite this, most papers deal only with the lumbar nodes. Therefore, the author performed the present experiments with the purpose to ascertain once again whether or not the lymphatic ducts running towards the pelvic lymph nodes have any great significance to corpus uteri.
Of the 12 cases with cervical carcinoma operated upon in our clinic during the period from January to June 1957, by injecting 1-3 cc of specially-prepared Indian black solution into the muscle layer at the base of uterus 21 hours before the operation, we observed the sedimentation of dye in the uterus and lymph nodes after hysterectomy both macroscopically and histologically.
As the result in all the cases we observed, besides the streaks of the dye sedimentation running from the base of the uterus to mesosalpinx, a marked dye sedimentation along the uterine arteries, enabling us to follow up the existence of the main vesseles flowing in the direction of the lymph nodes within the pelvis.
The percentage of the dye sedimentation is 100 per cent in the lumbar nodes; 70.8 per cent in the hypogastric nodes; 40.0 per cent in the upper iliac ncdes; 23.5 per cent in the obturator nodes; and 11.7 per cent in the lower iliac nodes. In other words, apart from the clear-cut existence of main vessels of corpus uteri flowing towards the lymph nodes (lumbar nodes) outside the pelvis as is generally accepted, it has been verified that there also exist main vessels running into the lymph nodes situated in the exterior side of the pelvis. That is to say, by a high degree of the dye sedimentation along the uterine arteries in the specimens prepared from the hysterectomized materials as well as by the dye sedimentation in the pelvic lymph nodes such as the hypogastric, the upper and lower iliac ncdes and obturator nodes there are the lymphatic ducts, running from the base of uterus by way of the lateral side of uterus along the uterine artery and reaching the hypogastric nodes, which seem to have a great significance as the main vessels of the corpus uteri just as much as those lymphatic ducts going outside the pelvis.
Therefore, it is necessary to give a second thought to the regional lymph nodes of corpus uteri, namely, apart from those lymph nodes (lumbar nodes) outside the pelvis, there are lymph nodes in the pelvis, the existence of which has often been ignored.
